OTALGIA IN INFANTS AND CHILDREN - A MANIFESTATION OF GASTROESOPHAGEALREFLUX

To investigate if there is a relationship between gastroesophageal ref lux and ear pain in the pediatric age group, a series of children pres enting with this picture were analyzed. Infants and children are often seen in an emergency room setting because of fretfulness, irritabilit y, and pulling on the ears. A diagnosis of otitis media is usually mad e, but in some cases the diagnosis may be referred otalgia secondary t o gastroesophageal reflux. Six children who presented with the above p icture were seen by one of the authors (W.S.G.) the following morning and noted to have a normal ear exam. These children were studied for g astroesophageal reflux by esophageal pH monitoring and in some cases e sophagoscopy with biopsy. All children exhibited gastroesophageal refl ux and an anti-reflux regimen eliminated the pattern of 'recurring oti tis media'. This paper will review the mechanism of referred otalgia a long with data supporting the concept of GE reflux as a cause of otalg ia in infants and children.